To describe the management of a case with skewed dental arches and midlines deviation using a novel approach based on temporary anchorage devices (TADs) to derogate the deviated arches by unilateral total arch mesialization. This study presents the treatment course of a 25-year-old man undergone a previous improper orthodontic treatment with unnecessary extraction of the upper and lower right first premolar teeth leading to asymmetric dental arches. The patient complained of dental crowding, an unaesthetic smile arch, and the maxillary and mandibular dental midline deviation. The proposed treatment plan goals were decrowding and correction of both arches asymmetry and achievement of coincident upper and lower dental midlines. The corrective treatment plan consisted of total arch mesialzation in both dental arches using an innovative TAD assisted jig. The overall treatment was accomplished in 28 months with significant improvement in facial aesthetic and reasonable periodontal status. This innovative clinical biomechanical setup of miniscrew-anchored sliding jig helped us achieve all the treatment goals (total dental arches mesialization, dental midline deviation correction, and ideal final aesthetic and occlusion) in a reasonable period of time. With proper planning, innovative designs based on TADs are effective alternatives in challenging cases such as uni or bilateral dental arches mesialization, and dental asymmetry correction.
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